Evidence map›Paper›PMID 40213499›Full record

ArticleThe Lancet regional health. Europe2025

Association of remnant cholesterol with unhealthy lifestyle and risk of coronary heart disease: a population-based cohort study.

Mia Ø Johansen, Signe Vedel-Krogh, Sune F Nielsen, Shoaib Afzal, George Davey Smith, Børge G Nordestgaard

Abstract read
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Article in The Lancet regional health. Europe, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Mia Ø JohansenDepartment of Clinical Biochemistry, Copenhagen University Hospital - Herlev and Gentofte, Denmark.
Signe Vedel-KroghDepartment of Clinical Biochemistry, Copenhagen University Hospital - Herlev and Gentofte, Denmark.
Sune F NielsenDepartment of Clinical Biochemistry, Copenhagen University Hospital - Herlev and Gentofte, Denmark.
Shoaib AfzalDepartment of Clinical Biochemistry, Copenhagen University Hospital - Herlev and Gentofte, Denmark.
George Davey SmithMRC Integrative Epidemiology Unit (IEU), Bristol Medical School, University of Bristol, United Kingdom.
Børge G NordestgaardDepartment of Clinical Biochemistry, Copenhagen University Hospital - Herlev and Gentofte, Denmark.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Unhealthy lifestyle is a major risk factor for coronary heart disease, which may be explained by elevated remnant cholesterol. However, this question remains incompletely clarified. In this study, we aimed to investigate whether elevated remnant cholesterol explains part of the excess risk of myocardial infarction and coronary heart disease in individuals with unhealthy lifestyle. Methods: We included 104,867 individuals (58,286 women and 46,581 men) from the Copenhagen General Population Study free from coronary heart disease at examination. During a median follow-up of 9.2 years, 2484 developed myocardial infarction and 3570 developed coronary heart disease. To understand explained risk from elevated remnant cholesterol due to unhealthy lifestyle on risk of myocardial infarction and coronary heart disease, we used mediation analyses. Findings: Current smoking, low physical activity, and low adherence to dietary guidelines were all associated with higher levels of remnant cholesterol. For current smoking, remnant cholesterol explained 15% (95% confidence interval: 9.7%-20%) of the excess risk of myocardial infarction and 16% (11%-21%) of the excess risk of coronary heart disease. Corresponding values for low physical activity were 20% (13%-27%) and 21% (15%-28%), and for low adherence to dietary guidelines 12% (6.6%-18%) and 14% (8.0%-19%), respectively. Results were similar in women and men separately and in analyses where each lifestyle factor were additionally adjusted for the other three lifestyle factors. Interpretation: Elevated remnant cholesterol explained part of excess myocardial infarction and coronary heart disease in individuals with an unhealthy lifestyle. Clinically, these novel findings underline the importance of both elevated remnant cholesterol and promotion of healthy lifestyle in primary prevention of myocardial infarction and coronary heart disease. Funding: Independent Research Fund Denmark; Johan Boserup and Lise Boserups Grant; Medical Research Council.

Indexed as

Atherosclerotic cardiovascular diseaseCholesterolLifestyleLipidsMyocardial infarctionNuclear magnetic resonance spectroscopyProspective cohort studyRemnant cholesterolRisk factors

Identifiers

PMID40213499
PMCPMC11984604

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.